alhambramd
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Hi guys!
Im an IMG from the Philippines and recently married, living here in SF Area, CA. My husband and I are determined to stay in the Bay Area, hence Im applying only to programs here. I have applied for a California Letter, and Im still waiting to complete my requirements. My problem is that the person handling my case said that by their standards, my clerkship was deficient in psychiatry and elective rotations.
Are there any other filipinos out there going through the same predicament? Anybody who has gone through the process already and survived? Your tips will be greatly appreciated...
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| alhambramd
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Hello everyone! I just thought it would be a big help for those in the same situation if I update you on what I am doing regarding my PTAL application.
After passing USMLE step 1, 2CK and 2CS, I finally contacted my licensing analyst, who told me I had to take a remedial rotation for 2 weeks psychiatry and 4 weeks in any elective of my choice. She gave me 2 options: one is to ask around and see if there are any local hospitals willing to take me for remedials, or second to go back to the institution that gave me a medical degree and do my remedials there.
For everybody's information, 1 week IS equivalent to 32 hours.
So here I am, making plans to return to the Phils. I cant help it, rules are rules. If that's what they need from me, then so be it. Everything will fall into place in due time. My licensing analyst is currently asking the dean of my medical school to prepare a proposal regarding the said remedial rotation, subject to their approval. After completion of the said rotation, all I need is a letter of completion from the dean, and I'll be all set.
Let's just hope I will still have time to meet the deadlines of the residency programs, and if not, that the programs will cut me some slack-- after all, I AM TRYING to comply with all the regulations here...
I do understand that they're just trying to uphold the quality of doctors in California. I find it comforting to know that if by some twist of fate I end up in the ER in the hands of an IMG, that this doctor's credentials have been placed under the strictest scrutiny and this doctor has been found capable and competent.
Good luck everyone!
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| leptospira
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hey i just got my step 1 results...204/82...would that be good enough to get me into a residency program in the US? well i know there r still the other steps but im a lil worried bout my score...and bout ur deficits...werent u informed when u were still here in the phils that u need to complete 30d of psychiatry? and what kinds of elctives do u lack? can u pls tell me ur scores? if u dont mind that is 
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| alhambramd
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Hi Leptospira!
First of all congratulations on your scores. For most programs, a score of 80 is good enough to submit an application. That's one foot in the door...
About my deficit, no I wasn't told that I needed 30 days of psych because for most programs, the 2 week pscyh is enough. I've had other batchmates who have successfully match into IM programs in Nevada and in New York. The curriculum wasnt a problem for them. There are just rules/standards for some states that are different from the rest...and California is one of the more "meticulous" states By their standards, I need to complete 2 more weeks of Psych (equivalent to 64 hrs) and 4 weeks of any elective of my choice (equivalent to 128 hrs)
Besides, I'm not a career-IMG ... what I meant is, for most of my days in medschool, I never thought I'd go into residency in the US. I spent my days preparing for a residency program in Manila. Sure, I toyed with the idea of US training, but I didnt really research into how it is done. Of course, life had other plans for me, and I fell in love and married a Fil-Am.
SCORES:
Step 1 203/ 83 after 6 months studying
Step 2 CK 209/ 85 after just 1 month studying!
Step 2 CS Passed after just 1 week studying!
ECFMG certified Oct 10, 2005
California letter/ PTAL with deficiencies
no visa required
Applied to 21 programs in the San Francisco Bay Area: 2 interview invitation/ no rejections yet (unless you count the polite "we didnt interview any IMGs last year, and it's probably unlikely to change for this year" email I got from Stanford)
Dont worry, if it's meant to be, it will happen for you... dont stress out about it 
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| leptospira
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thanks alhambramd! congratulations on ur scores ha...and with that time spent for reviewing! ur somwthing man!  ur reply has boosted my already limping confidence ! m in an internal med program her in the phils n wont be applying for a match until i finish here...or at least thats what im planning to do...i want to review for my step 2 with totally undivided attention so have to wait for another 2 y...and i dont have a visa yet...good for u! again thanks for the reply
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| Lorena
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hi alhambramd
sorry to post in your Phillipines thread but my situation is similar to yours.
I applied to california letter also, i am waiting for them to tell me what they said to you: defficiency in psychiatry so i already made arrangements and i will go to my homecountry Mexico and do a clerkship in a Psychiatric hospital. MY questions is ...what do you mean by defficiency in electives?
During my internship i did rotations in IM, FM, SUrgery, pediatrics, ER and OB/GYN..so do i have to do even more rotations??
I am sorry to ask you all this but i am just trying to figure out asap to do whatever i have to do to remedy my defficiencies for the Board of california.
thanks in advance
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| alhambramd
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Hi Lorena!
The rules on rotations is that you have to have a minimum of 72 weeks in the clinical courses(each week equivalent to 32 hours)
Instruction in the core clinical courses of surgery, medicine,family medicine, pediatrics, obstetrics and gynecology, and psychiatry shall total a minimum of 40 weeks in length with a minimum of eight weeks instruction in surgery, eight weeks in medicine, six weeks in pediatrics, six weeks in obstetrics and gynecology, a minimum of four weeks in family medicine, and four weeks in psychiatry.
Anything in excess of these 40 weeks counts towards your electives, which I guess is 32 weeks minimum (72-40= 32 right?)
Electives is a short rotation outside of the core clinical...examples are the subspecialties, dermatology, ENT-HNS, ophthalmology, radiology and the like. I've been able to talk with my licensing analyst and made her aware that in my primary hospital, our electives have 88 hour work weeks. She has agreed to put that under consideration, pending some sort of letter or certification from our Dean or Registrar attestng to the said number of hours. So hopefully, I wont have a deficiency in electives any longer... just the psychiatry part.
I should warn you though that not all hospitals are recognized by the California Medical Board, unless it is ACGME recognized or it is your primary hospital (the hospital where you went to clinical clerkship and is affiliated with your medical school). I suggest you get in touch with them first before investing any time and effort into extra rotations that might not even be recognized in the first place.
Wait the required 90 days from time of receipt. You will receive a letter from them acknowledging that they received you application and have reviewed it, and then they will list your deficiencies. This letter will have the name of your assigned licensing analyst along with his/her contact numbers. You can give your licensing analyst a call and leave a message and they wll get back to you within the day to discuss your issues.
Are you going for the 2006 match? That's cutting it a bit close I think  I've actually given up on a couple of hospitals I really liked, just because they require a PTAL even before your application is considered complete. And the application has to be complete before it is reviewed.
Chill!
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| alhambramd
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Hi leptospira!
I was just wondering why you are going through the IM program pa before applying for a program here... That was my dilemma kasi when I was trying to decide whether I will go into residency in the Phils first (as a matter of pride) or to just take the year off and devote my time to getting ECFMG certified. I realized kasi that even if I finish some sort of residency training in the Phils, it wont count for anything in the US. I will still have to go through everything all over again. So instead of taking up 3 years of my time going through residency, I thought I should just take up the 1 year reviewing and go for the 2006 match.
And since I wont be coming back to the Phils for a while, it wont be of much use to me even if I am certified as an internist there.
It's been a wonderful year, I've gotten married and been a housewife, and I had the unique opportunity of taking care of my mother in law when she succumed to CA. (Hence, the limited study time for step 2 CK and CS). I'm glad I took the year off...it's been the most wonderful year of my life.
But to each his own...I'm sure you have your reasons. I just thought I'd share what I went through. Good luck!
abi <-- received ECFMG certificate from FedEx just a couple of minutes ago, *sigh*
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| Lorena
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THank you SO MUCH for your reply!!!
I really appreciate you took the time to explain to me some very important things. I really hope i can get in the Cali area and maybe we can even be interns at the same hospital!
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| byan107
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hi alhambramd
from what medical school did you graduate?
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| alhambramd
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Very late reply, I know...
I graduated from Pamantasan ng Lungsod ng Maynila in 2002. I guess over here in the US, the official name of our medical school is University of the City of Manila (no kidding!)
I finally got my FINAL California Letter/ PTAL (without deficiencies) mid-December. Send it to ERAS immediately, and they, in turn, immediately lost it somewhere along the road. *SIGH* So after the holidays, I decided to re-send another copy, which they received on time and within 12 hours of receipt, uploaded into their database.
Within 24 hours of it getting uploaded, I started receiving more interview invitations... I knew it! That was the only thing those PDs were waiting for No really, I knew they were interested in me all along, I never had any doubts they would ask me to come over eventually Haha!
(The truth is, I had already given up on getting more invitations mid-December, but lo and behold, miracles still happen...oh joy, oh joy)
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| Transcriptio
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alhambramd
can u tell me the site in which i can start the process to make the california letter? do u have to be board certified before applying for it?? thanks
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| aifra
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Hi Transcriptio
Now u can start the process by submitting a basic form and the initial fee online and then send in the paper application later... go to:
http://www.dca.ca.gov/proflic/medicalbd.html
or
https://elicense.dca.ca.gov/iLicense/iLicense
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| alhambramd
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Hi Transcriptio!
You can read through the website of the Medical Board of California at http://medbd.ca.gov
You can read through my my more extensive posts on this topic elsewhere in this forum. Feel free to look for them.
Personally, I submitted a paper application. After all, you are paying online, but for the rest of the application, they will still require you to submit your forms by mail, and the processing times will still be "90 days" as their website claims.
Good luck!
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| alhambramd
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the CA letter (now known officially by the name "Postgraduate Training Authorization Letter/PTAL) is not "made"... at least not y the applicant personally. the Medical Board of California will write one in your behalf if, after careful review of your credentials from your medical education (and ONLY your medical education) and have found them "satisfactory" by US and California standards.
board certified? by what board? i dont understand what you mean...
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| Transcriptio
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To aifra/alhambramd: thanks for the site.. too many documents to complete!! esp the fingerprint card, what the heck is that? very helpful indeed.. couple questions here.. i only completed usmle step 1 here and still a medical student.. and the form says that u must graduate with ecfmg certified (pass step 1/2/cs) to be eligible to apply.... there is a problem in which my school doesnt have psychiatry rotation; we did have brief introductory course tho.. so does that mean my school wont be recognized? appreciate for u gus' response
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| alhambramd
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Hi Transcriptio...
It would serve you well to visit the website of the Medical Board of California at http://medbd.ca.gov . A lot of what you need to know is readily available there if you look hard enough (although it wont necessarily appease you all the time).
ECFMG certification is required for obtaining a physician's/surgeon's license, NOT for a CA letter/PTAL. For the purpose of the Match, all you need is the PTAL. Besides ECFMG certification, the requirements are essentially the same. Realistically, you CANNOT obtain a license until after you have had several months of training under an ACGME accredited residency program.
Psychiatry is a major rotation here in the US. The fact that your medical school doesn't have one definitely poses a problem for you. For any deficiency in your curriculum they usually give you two options: one is to do extra rotations back at you medical school, and the second is to find a program here in the US that will allow you to have your rotation there. In my experience, the 2nd option was just too hard because I didnt get a quick enough response from the programs, and personally I dont think they are that willing to take me on as a liability.
As far as MBC accreditation, you can check out the list of medical schools on the MBC website or just click on this link http://www.medbd.ca.gov/Applicant_Schools_Recogni...
One step at a time dude...chill!
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| landa29x
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how do you find the list of ACGME recognized hospitals outside the US? i went to the website but i don't understand how to find it
thx
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| alhambramd
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The link I provided in my previous post is for a page in the website of the medical board of california that has a list of medical schools that are accredited with them... you can use that list if you are applying for a CA letter
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| alhambramd
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But if you are really lokking for a list of ACGME accredited institutions, you can find it on the ACGME website at http://www.acgme.org/adspublic/
The list of medical schools outside of the US, you first have to check if they are accredited with ECFMG at their website at these links http://ecfmg.org/creds/index.html and http://imed.ecfmg.org/
There is a access to answers to all the questions on our minds on the internet... we just have to know where to look
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